•Subcutaneous fats layer thins leads to less insulation

PHYSIOLOGIC CHANGES IN AGING AFFECTING and padding –resulting to HYPOTHERMIA in cold

VARIOUS SYSTEM weather

INTEGUMENTARY CHANGES IN SKIN •Sweat glands produce less sweat

Layers of the Skin •Growths such as skin tags, warts, rough patches
a.) Epidermis (outer layer of the skin) contains skin (keratoses) and other blemishes are common in older
cells, pigment and protein people.

b.) Dermis (middle part) contains blood vessels, nerves, PREVENTION

hair follicles and glands. 1. Avoid long exposure to sunlight
-Provides nutrients to the epidermis 2. Use a good quality sunscreen when outdoors, even in
the winter
c.) Subcutaneous layer (the inner layer under the 3. Wear protective clothing and a hat when needed
dermis) contains sweat glands, some hair follicles, 4. Good nutrition and adequate fluids are also helpful
blood vessels and fats. 5. Keep skin moist with lotions and other moisturizers.
6. Do not use soaps that are heavily perfumed
•Each layer contains connective tissue with collagen 7.Bath oils are not recommended because they can
fibers to give support and
cause you to slip and fall
elastin fibers to provide flexibility and strength.

Factors affecting skin changes

MUSCULOSKELETAL CHANGES
1. environmental factors
2. genetic makeup
•Aging changes in the bones----muscles----joints
3. nutrition
4. sun exposure –the greatest single factor
SKELETON provides support and structure to the
body
Aging Changes
•Dry, wrinkled, sag skin (leading to the development of
BONES –do not directly contact with each other, they
elongated ears, jowls and double chin)
are cushioned by cartilage in the joint, synovial
membranes around the joint and fluid
•PHOTOAGING of the skin is the result of chronic
Ultraviolet radiation from sunlight and occurs most
JOINTS -are the areas where bones come together
often on exposed skin areas such as face and arms.
-allow the skeleton to be flexible for movement.

•Development of brown pigmented areas on the face,

hands and arms
MUSCLES –provide the force and strength to move
the body
(Lentigo senilis) sometimes called as liver spots or
age spots.
AGING CHANGES
•People lose bone mass and density as they age
•Hair loses its original color as the production of
especially women after menopause
melanin decreases, turning it gray and eventually white.

•Hair tends to thin both on the head and elsewhere on •The spine is made up bones called vertebrae. Between
the body. each bone is a gel-like cushion (called a disk). The
middle of the body (trunk) becomes shorter as the
disks gradually lose fluid and become thinner.
•Nails thicken and becomes more brittle
•Vertebrae lose some of their mineral content, making
each bone thinner.
•Blood vessels of the dermis become more fragile

•The spinal column becomes curved and compressed

senile purpura –bleeding under the skin
(packed together)
•Sebaceous produce less oils resulting to dryness and
itchiness of the skin
•Foot arches become less pronounced, contributing to a
slight loss of height.
•The long bones of the arms and legs are more brittle •Teach safety measures, including fall prevention
because of mineral loss,but they do not change length. measures to clients and care givers.

•Joints become stiffer and less flexible AGING CHANGES IN THE NERVOUS SYSTEM

•The brain and nervous system are body’s central

•Hip and knee joints may begin to lose cartilage
control center. It controls the body’s:

•Lean body mass decrease

 Movements

•Lipofuscin (age related pigment) and fat are

 Senses
deposited in muscle tissue

 Thoughts and memories

•Muscles are less toned and less able to contract

EFFECT OF CHANGES
•Bones become more brittle and may break more easily Aging Changes and their Effects on the nervous
System
•Overall height decreases because the trunk and spine
shorten •Brain and spinal cord lose nerve cells and weight which
can cause abnormal changes in the brain called plaques
•Breakdown of the joints may lead to inflammation, and tangles to form
pain, stiffness, and deformity
•Breakdown of nerves can affect your senses
•Posture may become stooped (bent)
•Slowing of thought, memory, and thinking
•The knees and hips may become more flexed Nervous System Problems in Older People

•The neck may tilt, and the shoulders may narrow while
•DEMENTIA and severe memory loss are not a normal
the pelvis becomes wider
part of aging.

•Movement slows and may become limited

-they can be caused by brain disease such as
ALZHEIMER DISEASE, which doctors believe is
Common problems
associated with plaques and tangles forming in the
1. Osteoporosis
brain and the build up
of lipofuscin
2. Muscle weakness contributes to fatigue, weakness,
and reduced activity intolerance. •DELIRIUM is sudden confusion that leads to changes
in thinking and behavior
3. The risk of injury increases
•Thinking and behavior problems can also be caused by
poorly controlled diabetes
4. Reduced reflexes
PREVENTION PREVENTION
•Exercise is one of the best ways to slow or prevent 1. Mental and physical exercise can help your brain
problems with the muscles joints, and bones. sharp. Mental exercises include reading, doing
crossword puzzle and stimulating conversation
•Eat a well-balanced diet with plenty of calcium include
dairy products and green leafy vegetable
2. Teaching safety measures
Post menopausal women and men over 70 should take in
1,200mg of calcium/day CARDIOVASCULAR CHANGES
•The heart has two sides. The right side pumps blood
Women and men over age 70 should get 800 to the lungs to receive oxygen and get rid of carbon
international units (IU) of vitamin D daily. dioxide.
•The left side pumps oxygen-rich blood to the body.

•Blood flows out of the heart through arteries, which

REPRODUCTIVE SYSTEM (MALE)
branch out and get smaller and smaller as they go into
•Aging changes in the male reproductive system may
the tissues.
include:

•In the tissues, they become tiny capillaries

-changes in the testicular tissue
-sperm production
•Capillaries are where the blood gives up oxygen and
-erectile function
nutrients to the tissue, and receives carbon dioxide
and wastes back from the tissues.
Andropause –the gradual changes that occur in male
during this process
•The vessels begin to collect together into larger and
larger veins, which return blood to the heart
Changes in Men
•As men age, the testes become softer and smaller as
Result of aging
a result of decreased concentration of testosterone in
1. Functioning of the cardiovascular system becomes
the bloodstream
less efficient

•Production of sperm is inhibited or decreased

2. Reduced elasticity of the heart muscle and arteries
causes a subsequent increase in systolic blood pressure
•Ejaculation is less forceful

•Sexual dysfunction increases –may be related to

3. Increased fat deposits in the blood vessels lead to a
erection, ejaculation, orgasm partner-related issues
reduced supply of oxygen

•Erectile dysfunction or impotence –inability to achieve

4. Arterial diameter decreases as a result of or maintain an erection sufficient for sexual
arteriosclerosis dysfunction

5. Thickening of aortic and mitral valves leads to -affects as many as 2/3 of all men over 70.
incomplete closure -maybe caused by vasculogenic, neurologic, hormonal or
Result of aging psychogenic factors

6. Both arteries and veins become fibrotic •Prostate gland enlarges with age as some of the
prostate tissue is replaced with scar like tissue
7. Endothelial cell variation increases condition is called Benign Prostatic Hyperplasia
Benign Prostatic Hyperplasia (BPH) –affects about
Effect of Changes 50% of men.
-may cause problem with slowed urination and
•The things that make your heart work harder are: ejaculation

-certain medicines (WOMEN)

-emotional stress
-physical exertion •Decline in the serum level of estrogen resulting to
-infections thinning of the vaginal walls and vaginal secretion
-injury decreases.

PREVENTION •Vulva, external genitalia and breast shrink because of

•Eat a heart-healthy diet with reduced amounts of loss of subcutaneous body fat
saturated fat and cholesterol and control your weight.
•Bone demineralization
•Get more exercise
•Sleep disturbance
•Have a regular check-up for your heart
•Emotional symptoms, hot flashes, and diaphoresis
 nonjudgmental manner when clients discuss their
concerns about the physical changes.
MANAGEMENT
•Estrogen replacement therapy GASTROINTESTINAL CHANGES
•The health of our digestive system sometimes known
•To help manage problems such as painful sexual as the body’s
intercourse, use lubricant during intercourse
“second brain” –has a profound effect on the overall
•Getting regular exercise, eating healthy foods and health because it’s the source of our body’s ability to
staying involved in activities with friends and loved nourish itself.
ones can help the aging process go more smoothly.
•To understand the journey our food makes every day,
ENDOCRINE CHANGES use the illustration as your reference:
•The endocrine system consists of a group of glands
and organs that regulate and control various body 1. Elderly may have missing teeth or gum problems
functions by producing and secreting hormones. making it hard for them to chew and break down food –
first step in digestion
HORMONES-are chemical substances that affect the
activity of another part of the body.
2. Elderly may have a decrease in saliva production
Hormones that decrease include: making it hard to mix and mingle liquid and food in
preparation for swallowing.
-Estrogen (in women) -decline levels leads to
Menopause 3. The lower esophageal sphincter -which regulates the
flow of food from the esophagus into the stomach can
-Testosterone (in men) -usually decrease gradually weaken. This may result a regurgitation of food or acid
known as acid reflux, GERD and heartburn.
-Growth hormone –decreased levels of growth
hormone may lead to decreased muscle mass and 4. Elderly may not be producing enough hydrochloric
strength acid in the stomach leading to a decrease in the ability
to digest the protein and thereby increasing cravings
-Melatonin –decreased levels may play an important in the other two food groups –carbohydrates and fats.
role in the loss of normal sleep-wake cycles (circadian
rhythms) with aging 5. Elderly may not be producing as many digestive
Hormones that usually remain unchanged or any enzyme leading to increase in food sensitivities and
slight decrease include: intolerances.

-Cortisol 6. Elderly may not be producing as much bile in the

-Insulin liver making it more difficult to digest fats and leading
-Thyroid hormone to impaired thyroid function and hormonal problems.

Thyroid gland is responsible for maintaining our 7. Elderly may develop a leaky gut –meaning intestinal
metabolism barrier has become permeable –allowing pathogens to
systematically enter in the blood stream and tissues.
Alteration in pancreatic activity
8. Elderly lose muscle tone in digestive tract –just as
The major changes affecting men are enlargement of we lose muscle tone elsewhere as we age –causing the
the prostate gland (benign hypertrophy) and decreased food to move slowly through the digestive tract
reserves of testosterone ( known as decreased motility) resulting in fecal
incontinence and constipation.
The age-related changes for women include a loss of
elasticity in breast tissue with resultant sagging of the 9. Finally elderly may have accumulated a toxic burden
breasts, decreased size of uterus and fallopian tubes, as they age that impacts their colon.
and decreased motility of fallopian tube
MANAGEMENT
The nurse must provide information about the normal 1. Drink more water
changes associated with aging and listen in a
2. Eat more fiber (fruits and vegetables) -cataracts
-night blindness
3. Exercise more often -presbyopia

Most elderly people experience a decreased ability to

4. Reduce processed foods see colors; pastels fade and monotones, blacks, and
whites are difficult to see.
5. Avoid prescription drugs with gastrointestinal side
effects HEARING
•There is drying and wrinkling of the auricle with a
noticeable increase of hair in the auditory canal
6. Take care of your teeth and gums

•Cerumen becomes drier and can cause impaction

7. Limit sugar intake which blocks transmission of sound

GENITOURINARY CHANGES •PRESBYCUSIS –hearing loss associated with aging

a.Even without kidney disease aging causes the kidneys

•In the middle ear, bony joints show some
to lose some of their ability to concentrate urine.
degeneration
b.Beginning at about age 40, there is a decrease in the
number and size of the nephrons. Often, more than •Inner ear degeneration of the vestibular system and
50% of the nephrons are lost before age 80. simultaneous atrophy of the cochlea and the Organ of
Corti produce deficits in equilibrium and hearing.
C.There may be an increase in blood urea nitrogen
(BUN) without serious symptoms.
TASTE and SMELL
d. The elderly are more susceptible than young people
to infections of the urinary system. •Taste perception declines

e. Childbearing may have caused damage to the •Salivation is diminished

musculature of the pelvic floor

•Chewing problem associated with loss of teeth and use

f. Enlargement of the prostate, common in older men,
of dentures also interfere with taste sensation and
may cause obstruction and back pressure in the
cause reduction in saliva production
ureters and kidneys.

•Other factors that can affect one’s sense of taste

include poor oral hygiene, poor nutrition, tooth decay,
g. Age changes may predispose a person to and certain medications and treatments such as
incontinence, but age changes do not cause a person to chemotherapy and radiotherapy.
be incontinent.
•By the time a person reaches 50 years of age, their
SPECIAL SENSES sense of smell sometimes be only half as sharp as it
was in their youth.
VISION
Most older adults tend to suffer from vision •The reason for this decline are as follows:
depreciation as a result of one of three main
causes: -poor nasal hygiene
-reduced ocular muscle tone -nasal congestion
-reduced eye lubrication -disease affecting the nose or sinuses
-an eye disorder, injury, or disease -certain neurological conditions, and/or certain
medications and treatments
Most common eye disorders to affect older adults
are:
-glaucoma HYPOSMIA –reduced ability to smell and to detect
-Age-related macular degeneration odors
TOUCH
•As we age, our sense of touch often decline due to
skin changes, and reduced blood circulation to touch
receptors or to the brain and spinal cord

•Skin or nerve damage caused by diabetes, neurological

disorders, mental illnesses, and brain disorders

•Certain medications and treatments can also affect

touch sensation

•Deficiency in thiamine may be a cause of changes

RESPIRATORY CHANGES
•Most older adults experienced a decreased functional
respiratory reserve capacity, with a generalized
decreased elasticity and tone muscles including the
muscles necessary for respiration

•Physical change in the lungs include fewer functioning

alveoli and a decreased number of cilia

•Thoracic inspiratory and expiratory muscles are

weaker

•Anterior-posterior chest diameter increases often

demonstrated by kyphosis

•Blunting of the cough and laryngeal reflexes

•Cilia are reduced in number

•There is hypertrophy of the bronchial mucous gland

•The lungs become smaller and more rigid and have less
recoil

Some of the most common lung diseases in elderly

are as follows:
-asthma
-lung cancer
-chronic bronchitis
-emphysema
-pulmonary embolism